RESUMO
Female reproductive mucosa must allow allogenic sperm survival whereas at the same time, avoid pathogen infection. To preserve sperm from neutrophil attack, neutrophils disappear from the vagina during the ovulatory phase (high estradiol); although the mechanisms that regulate neutrophil influx to the vagina during insemination remain controversial. We investigated the sex hormone regulation of the neutrophil migration through the cervix during insemination and revealed that ovulatory estradiol dose fades the CXCL1 epithelial expression in the ectocervix and fornix; hence, retarding neutrophil migration and retaining them in the epithelium. These mechanisms spare sperm from neutrophil attack to preserve reproduction, but might compromise immunity. However, luteal progesterone dose promotes the CXCL1 gradient expression to restore neutrophil migration, to eliminate sperm and prevent sperm associated pathogen dissemination. Surprisingly, these mechanisms are hormone dependent and independent of the insemination. Thus, sex hormones orchestrate tolerance and immunity in the vaginal lumen by regulating neutrophil transepithelial migration in the fornix and ectocervix.
Assuntos
Colo do Útero/imunologia , Quimiocina CXCL1/metabolismo , Estradiol/metabolismo , Inseminação/imunologia , Neutrófilos/imunologia , Animais , Colo do Útero/citologia , Colo do Útero/metabolismo , Receptor alfa de Estrogênio/genética , Receptor alfa de Estrogênio/metabolismo , Feminino , Tolerância Imunológica , Masculino , Camundongos , Camundongos Knockout , Mucosa/imunologia , Mucosa/metabolismo , Neutrófilos/metabolismo , Espermatozoides/imunologia , Espermatozoides/metabolismo , Migração Transendotelial e Transepitelial/imunologiaRESUMO
PURPOSE: To identify the clinical risk factors for the development of severe proliferative vitreoretinopathy (PVR) after scleral buckling procedures for retinal detachment (RD). METHODS: A retrospective study of 124 patients with rhegmatogeneus RD treated initially with buckling procedures, with either no PVR or with no PVR of grade C-l or less at initial examination was conducted. After surgery, severe PVR was defined as grade C-2 or worse. Univariate analysis and stepwise logistic regression evaluated the data relating to 34 statistical series (96 variables). RESULTS: Severe PVR develop after surgery in 13 patients (10.48%). Seven significant predictive variables were identified: grade A preoperative PVR (p=0.005), detachment involving more than 2 quadrants (p=0.019), preoperative vitreous traction (p=0.002), intravitreal injection (p=0.046), scleral perforation (p=0.001), unsealed break (p=0.001), and postoperative vitreous traction (p=0.012). CONCLUSIONS: The results indicate that in addition to the extent of detachment, and presence of preoperative inflammation or low grade PVR, iatrogenic problems also are important factors in the pathogenesis of severe PVR after surgery for RD.